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Poikiloderma of civatte problem - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Average Posted in: Skin Hair and Nails
Answered by

General & Family Physician
Practicing since : 2008
Answered : 2685 Questions
User :   I was diagnosed by a doctor as having Poikiloderma of Civatte. However, it only appears on my chest (not the sides of my neck) and seems to come and go, sometimes invisible and sometimes bright red. It's worse when I drink alcohol. I also haven't had a great deal of sun exposure although I have burned my chest on several past occasions ad am very fair skinned (scottish genes). I had another strange rash which was accompanied by joint pain and soft tissue pain and both lyme's and lupus have been ruled out. This other strange rash and it's other sx only happened twice, once 10 years ago and again last year. It's gone now. Is it possible I didn't get the right diagnosis? When I had a biopsy of the other rash the dermatologist said he saw cells that suggested a lot of allergic activity. Nothing else. I did not mention the redness of the chest at the time, not thinking they were related. Is it possible I got the wrong diagnosis? It was a gp NOT a dermatologist who diagnosed the Poikiloderma of Civatte and then suggested laser treatment which I did. Thanks!
Doctor :   HI
User :   Hi
User :   are you familiar with Poikiloderma of Civatte?
Doctor :   Yes
User :   and?
Doctor :   Wait few sec
User :   ok
Doctor :   the history is big
Doctor :   I have to understand
User :   sure
Doctor :   Do you currently have rash?
User :   you mean the flushing on my chest?
Doctor :   Can you describe the rash when you had>
Doctor :   Just flushing!
Doctor :   are there any rasied pimple like rash?
User :   now yes. I had two instances ten years apart of a rash that looked very much like lyme, but tested neg both times and for lupus as well.
User :   no pimples, just looks like a sunburn, but it comes and goes with no exposure to sun
Doctor :   if you are tested for lyme and lupus delete them
Doctor :   they are not the cause
User :   good news! what can cause this chest flushing?
Doctor :   Poikiloderma of Civatte presents as chronic reddish-brown discoloration on the lateral cheeks and neck
Doctor :   I can sun it just hyperpigmented rash
User :   it's not reddish brown, just red, really just looks like I'm sunburned except I'm not and it changes throughout the day
Doctor :   ofcourse, red
Doctor :   exactly!
Doctor :   photo sentive area effected
User :   and it's not on my neck, just chest
Doctor :   not at all on neck
Doctor :   not at all on neck ?
User :   it looks more like vascular dialiation than pigmentation
Doctor :   yes it is
Doctor :   this is called telangiectasia
User :   not on neck at all unless the flushing rises up that far on really bad day - or had alcohol
User :   right. that's a sx not a condition right?
Doctor :   yes
User :   any way to treat it?
User :   its driving me crazy!
Doctor :   were there any white scaly rash along with red rash
User :   no
User :   dont even know it's there until i look in the mirror
User :   seems just like very sensitive skin but I'd like to be able to un-dialate the vessels with something
Doctor :   was it itchy?
User :   never
Doctor :   so it is not eczema
User :   no way
Doctor :   it is not Psoriasis
User :   no way
User :   no lesions
Doctor :   One thing I am sure : User :   just flushing
Doctor :   It is sun allergy related
Doctor :   1. avoiding sun exposure and the proper use of sunscreens is most important.
2. intense pulsed light systems have been used and found to be effective in the treatment of poikiloderma of Civatte
User :   it happens with no exposure to sun. I NEVER expose my chest to sun
Doctor :   ok
User :   so you think its the right dx?
Doctor :   Ultraviolet ray i sun cause the allergy
Doctor :   You need directly expose the chest
User :   but my chest never gets sunlight EVER
User :   sorry don't understand last point you made
Doctor :   Even if u do not directly expose chest to sun
Doctor :   The sun emitted Ultra violet rays will reach the skin
Doctor :   and they cause allergic photo reaction
User :   How? through my clothes to my chest?
Doctor :   Yea
User :   OK. I live in Vancouver, and wear black turtle necks . NO way
Doctor :   Alright dude
User :   it happens at night
Doctor :   I have 20 disease here with me
User :   dude?
Doctor :   I have read all
User :   you have 20 diseases?
User :   don't understand
Doctor :   Other diseases have different kind of rash
Doctor :   the rash u described the fits into the disease you described
Doctor :   Poikiloderma of Civatte
Doctor :   Telangiectasia responds to laser
User :   So Poikiloderma of Civatte can flare up and then die down sort of thing?
Doctor :   Yes it is
User :   I see. And pretty much laser is the only option right?
Doctor :   Yes
User :   bummer!
User :   I've heard skin lightening creams may work: hydroquinone or something like that?
Doctor :   I hope you are getting the treatment under Dermatologist surveillance . Right!
User :   Not for this, just laser tx from a doctor.
Doctor :   I recommend you get consultation with Dermatologist
User :   I thought that is what I was doing here!
Doctor :   This is not live
Doctor :   This is different approach
User :   I was looking for a second opinion, but I will make an appt with my dermatologist.
User :   any other suggestions? Metrogel?
Doctor :   No
User :   no chance it's roceasa right?
Doctor :   You did not tell me there are acne like rash
User :   there isn't but I just thought because of the redness
Doctor :   so it is not chest acne or roracea
Doctor :   *rosacea
User :   I don't know enough about rosacia to tell
User :   but any acne I have on my chest I think is unrelated and my derm says its likely folliculitis
User :   pardon my spelling!
Doctor :   Your very good
Doctor :   Very polite
Doctor :   like the way you chat
Doctor :   Rosacea is a chronic skin condition involving inflammation of the cheeks, nose, chin, forehead, or eyelids.
User :   ok, so not the chest...totally different thing it seems
Doctor :   There is Redness of the face in discrete areas or covering the entire face
Doctor :   A tendency to flush or blush easily
User :   that's me!
Doctor :   ncreased number of spider-like blood vessels (telangiectasia) of the face
User :   none of that!
Doctor :   these are rocea symptoms
Doctor :   they appear mainly on face
Doctor :   just by looking face somebody can tell it is rosacea
User :   none of the inflamation on my chest looks spider like
Doctor :   so u do not have rosacea
User :   yay!
Doctor :   some times there will be bad acne on chest
Doctor :   but u know acne
Doctor :   it presents as lapules
User :   when I was younger this was the case
Doctor :   *papules
Doctor :   where you stay in vancouver
User :   kerrisdale
Doctor :   May I know your gender?
User :   female
Doctor :   My wife is in Uinversity Canada west
User :   cool!
Doctor :   I might visit her soon
Doctor :   what is your #
Doctor :   be cool
Doctor :   Even though Vancouver is cool
Doctor :   protect from sun
Doctor :   Get laser Rx
Doctor :   Do you have any questions?
User :   I think that's it! Thanks for your help.
Doctor :   Good night
Doctor :   Thank you for consulting
Doctor :   Bye
User :   good night
Doctor :   it day for me
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